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Aspirin benefited colon cancer patients with key gene mutation
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Post-diagnosis aspirin therapy is associated with longer survival in patients with a PIK3CA-mutated colon cancer, according to study results.
Regular aspirin therapy after colorectal cancer diagnosis use has been associated with better clinical outcomes. Previous research suggested aspirin blocks the enzyme PTGS2, causing the deceleration in signaling activity of the enzyme PI3K. Doctors and clinicians do not currently have the ability to predict which patients will benefit from aspirin treatment, although it is routinely prescribed to patients with colon cancer. Researchers in this study hypothesized that aspirin’s effect on survival might differ in patients with PI3K-activated, PIK3CA-mutated cancers from those with PIK3CA wild-type cancers, according to background information in the study.
Xiaoyun Liao, MD, PhD, research fellow in the department of medicine at the Dana-Farber Cancer Institute, and colleagues obtained data from 964 rectal and colon cancer cases in the Nurses’ Health Study and the Health Professionals Follow-up Study. Researchers followed patients until death or January 2011, whichever came first.
Data included details of the patients’ use of post-diagnosis aspirin and the presence or absence of PIK3CA mutations in their tumor tissue.
Results of the study indicated 395 deaths overall, including 190 colon cancer-specific deaths.
Researchers’ median follow-up was 153 months.
Among patients with PIK3CA-mutated tumors, post-diagnosis aspirin therapy was associated with a significantly better cancer-specific survival (HR=0.18; 95% CI, 0.06-0.61). Among patients with PIK3CA wild-type cancers, post-diagnosis aspirin therapy was not associated with cancer-specific survival (HR=0.96; 95% CI, 0.69-1.32).
According to the results, the effect of aspirin on survival among patients with colon cancer appeared consistent, irrespective of dose.
Colorectal cancer patients with PIK3CA-mutated tumors who routinely use aspirin received a sharp boost in survival, suggesting that the gene mutation may serve as a potential molecular biomarker for aspirin therapy, according to results from the study.
Among those with PIK3CA-mutated tumors who did not use aspirin therapy, 23 of 90 patients (26%) died within 5 years after diagnosis vs. two of 62 patients who regularly used aspirin therapy (3%; P<.001).
“Our results suggest that aspirin can be particularly effective in prolonging survival among patients whose colorectal cancer tests positive for a mutation in PIK3CA,” Shuji Ogino, MD, PhD, MS, associate professor in the department of epidemiology at the Harvard School of Public Health, said in a press release. “For the first time, we have a genetic marker that can help doctors determine which colorectal cancers are likely to respond to a particular therapy.”
Ogino said the study results must be replicated by additional researchers before the results can be considered definitive.
Disclosure: Liao and Ogino report no relevant financial disclosures. One researcher was a consultant for Bayer Healthcare, Millennium Pharmaceuticals and Pfizer.
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